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A 46-Year-Old Man With Dyspnea, Dysphagia, and Pulmonary Hypertension*

Xin Yao, MD; Elizabeth Gilmore, DO; Kenneth Nugent, MD, FCCP
Author and Funding Information

*From the Departments of Internal Medicine (Drs. Yao and Nugent) and Pathology (Dr. Gilmore), Texas Tech University Health Sciences Center, Lubbock, TX.

Correspondence to: Kenneth Nugent, MD, Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430; e-mail: kenneth.nugent@ttuhsc.edu


Chest. 2008;133(3):812-815. doi:10.1378/chest.07-1871
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A 46-year-old man presented to the emergency department with a 2-day history of dyspnea on exertion, orthopnea, productive cough, and pleuritic chest pain. He had no fever or chills. His medical history was significant for type II diabetes mellitus and acute myocardial infarction. Current medications included aspirin, enalapril, atorvastatin, metoprolol XL, and metformin. He had a 40-pack-year history of cigarette smoking. He had no history of alcohol or IV drug use. He was married and had no risk factors for HIV infection. A review of systems revealed decreased appetite, a 25-lb weight loss over 2 weeks, and intermittent dysphagia for 2 weeks. He had no skin lesions, skin tightening, heart burn, arthralgias, hematuria, or history of cytopenias.

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